2024 ahcccs complete care The ACC program is administered by AHCCCS in partnership with five managed care organizations (MCOs) that have been selected through a competitive bidding process. The MCOs are responsible for providing a broad range of services to ACC members, including primary care, specialty care, hospitalization, behavioral health, and LTSS. ACC members are assigned to an MCO based on their county of residence and the type of services they need. Once enrolled, members have access to a network of providers that have been contracted by the MCOs. Members can choose their primary care provider (PCP) from this network and can also access specialists, hospitals, and other providers as needed. The ACC program includes several key features that are designed to improve the quality of care for members. These features include: 1. Care Coordination: ACC MCOs are required to provide care coordination services to members, including the development of individualized care plans, the coordination of services across providers, and the provision of care management services to high-need members. 2. Disease Management: ACC MCOs are required to provide disease management programs for members with chronic conditions, such as diabetes, asthma, and heart disease. These programs are designed to help members manage their conditions and prevent complications.
In addition to improving the quality of care for members, ACC is also designed to control costs. ACC MCOs are paid a fixed monthly amount per member, regardless of the amount of services they use. This payment model is designed to encourage MCOs to provide efficient, cost-effective care. ACC members are assigned to an MCO based on their county of residence and the type of services they need. Once enrolled, members have access to a network of providers that have been contracted by the MCOs. Members can choose their primary care provider (PCP) from this network and can also access specialists, hospitals, and other providers as needed. The ACC program includes several key features that are designed to improve the quality of care for members. These features include: 1. Care Coordination: ACC MCOs are required to provide care coordination services to members, including the development of individualized care plans, the coordination of services across providers, and the provision of care management services to high-need members. 2. Disease Management: ACC MCOs are required to provide disease management programs for members with chronic conditions, such as diabetes, asthma, and heart disease. These programs are designed to help members manage their conditions and prevent complications. 3. Behavioral Health Integration: ACC MCOs are required to integrate behavioral health services with physical health services. This means that members can access both physical and behavioral health services through their MCO, and that providers are encouraged to work together to address members' needs.
ACC MCOs are also required to meet a range of performance measures, including measures related to access to care, quality of care, and member satisfaction. AHCCCS uses these measures to monitor the performance of the MCOs and to ensure that members are receiving high-quality care. In addition to improving the quality of care for members, ACC is also designed to control costs. ACC MCOs are paid a fixed monthly amount per member, regardless of the amount of services they use. This payment model is designed to encourage MCOs to provide efficient, cost-effective care. ACC MCOs are also required to participate in value-based purchasing (VBP) arrangements with AHCCCS. VBP is a payment model that rewards MCOs for providing high-quality care and achieving specific performance targets. VBP arrangements are designed to incentivize MCOs to invest in programs and services that improve the health of their members and reduce costs over time. In conclusion, AHCCCS Complete Care is a comprehensive, capitated managed care program that provides physical health, behavioral health, and long-term services and supports to members of the Arizona Health Care Cost Containment System. ACC is designed to improve the quality of care for members, streamline the delivery of services, and control costs. ACC includes several key features, such as care coordination, disease management, behavioral health integration, long-term services and supports, and cultural and linguistic competence, that are designed to improve the quality of care for members. ACC MCOs are also required to meet performance measures and participate in value-based purchasing arrangements with AHCCCS.
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